Cold Cap or Hypothermia Cap Treatment has been referred to as resetting the brain by some doctors. They believe that it is one of the treatments that can minimize the effect of hypoxic-ischemic encephalopathy (HIE) – a condition where the baby has been deprived of oxygen long enough to cause injury to the brain. It can lead to cerebral palsy, mental retardation, and death.
In the United States alone, the incidence rate of HIE is 1-3 per 1000 live births. The mortality rate (death rate) is 10% to 60% while the morbidity rate (the condition itself) is 25%. Ninety percent of HIE is due to umbilical cord compression or when the cord is wrapped around the baby’s neck, fetal hemorrhage, and placental abruption. Ten percent happens after delivery.
What is a Cold Cap and how is it used?
A cold cap is a device that cools the brains of babies who suffered from neonatal asphyxia. The goal is to minimize or even prevent brain damage. Cooling the brain in this manner is very temperature and time specific. The brain’s temperature must be lowered to 82.4 degrees Fahrenheit for 72 hours and the treatment should start six hours after the baby is born in order for the brain cells to recuperate and minimize apoptosis or cell death.
Some simultaneously cool the core body temperature as well; from 98.6 degrees Fahrenheit to 92.3 degrees Fahrenheit. The baby is placed on a cooling blanket whilst being strictly monitored by healthcare experts for any changes.
Experts see this treatment as a neuroprotection or a way to protect the neurons from further injury or death by reducing the baby’s metabolic rate and energy consumption.
The modality of Cold Cap treatment may be fairly new, but the concept is not. Targeted Temperature Management has been used for many years. In fact, the Father of Medicine himself, Hippocrates, championed the use of ice in packing wounds of soldiers. The first medical application of hypothermia was in the 1950s during an intracerebral aneurysm surgery.
However, it was the powerful effect of cooling down during cardiac surgery that prompted researchers to delve into it further, and to what extent it can be used. Myron Ginsberg’s work in 1989 was believed to have propelled the interest in cooling the brain to minimize the outcome of oxygen deprivation. Soon after, trials and further exploration about the treatment that specifically targets babies was done.
Who can benefit from it?
Unfortunately, not all will qualify for the treatment. Certain criteria need to be met before the treatment can be done. During the research about Cold Cap Treatment in the 90s until early 2000s, the babies that were picked were born full-term, they did not have any medical condition prior to birth, they were in neonatal distress, and had an abnormal neurologic findings.
The outcome greatly depends on different factors. In other words, Cold Cap treatment is not a definite solution. However, various successful cases have been reported since the pilot study in Auckland by Tania and Alistair Gunn. The result in one of the clinical studies was more than promising. The study involved 243 infants with brain cell injuries ranging from moderate to severe. The result of head cooling with severe brain cell injury was ‘not protective’ while those who suffered moderate injury was ‘protective’.
Like all other things, the treatment has been accepted by some and doubted by others. It has produced good results but it is still in the developmental stage. The thing that you should pick up on this is that there is an option such as Cold Cap treatment in making the lives of babies who suffered from asphyxia better in the long run. That’s the main goal of the brilliant experts who tirelessly study the effect of this treatment. They just don’t want the babies to live; they want the babies to have productive and healthy lives as well.